Individual provider Active NPI

Jamicia Lanece Davis, PHD, LCSW

  • Clinical Social Worker
  • Hampton, VA
National Provider Identifier
1528537271
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904008322 Issued in VA
Practice address
324 Lynnhaven Dr
Hampton, VA 23666-2300
Phone
(757) 755-3423
Fax
(757) 755-3424
NPI assigned
Nov 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904008322 VA Primary

Addresses

Primary practice location

324 Lynnhaven Dr
Hampton, VA 23666-2300

Mailing address

324 Lynnhaven Dr
Hampton, VA 23666-2300
Phone (757) 755-3423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190313001858 VA Practitioner - Clinical Social Worker 4082954862 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Endurance Counseling and Supervision Services, LLC Clinical CurrentSince Mar 11, 2022 Accepting new patients

Locations

1706 Todds Ln
Hampton, VA 23666
Phone (757) 715-5263

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1528537271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 LYNNHAVEN DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662300",
            "telephone_number": "757-755-3423",
            "fax_number": "757-755-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 LYNNHAVEN DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662300",
            "telephone_number": "757-755-3423",
            "fax_number": "757-755-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAMICIA",
        "middle_name": "LANECE",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-23",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

Verify at the official NPI Registry.